It is common knowledge that high blood sugar is the hallmark sign of diabetes, but did you know that long before there are measurable changes in blood sugar, there are changes in insulin levels and the body’s response to it happening on a cellular level. These invisible changes are setting the stage for type 2 diabetes and other chronic diseases. This is all happening under the radar and the majority of people (and their healthcare providers) do not even know it is happening. Why is it that we don’t know this is happening? It’s mainly because we focus on blood sugar, but well before blood sugar tests start to show abnormalities, hyperinsulinemia (high insulin levels) and insulin resistance are building. To better understand this, let’s recap insulin’s action for controlling blood sugar. The food (mainly carbohydrate) that you eat is broken down into blood sugar. Blood sugar (glucose) then enters your bloodstream, which signals the pancreas to release insulin. Insulin acts like a key to help blood sugar enter the body’s cells so it can be used for energy and insulin also signals the liver to store blood sugar for later use in the form of glycogen. As the sugar enters your cells, the levels in the bloodstream decrease. This drop in blood sugar then signals for insulin to decrease too. The lower levels of insulin then alert the liver to release the stored blood sugar so energy is always available, even if you haven’t eaten for a while. It also signals to our fat cells to start to release stored fat to be used as energy as well.
This is how it goes when everything works the way it is supposed to, but if insulin is constantly signaled to be released due to us constantly feeding ourselves, eating a diet high in processed carbohydrates, and or a lack of exercise, it causes the cells to become less responsive to insulin’s signal. Think of it like the cells are tired of being nagged by insulin’s signal and so start to tune it out a bit. Initially, the pancreas responds to the resistant cells by making more and more insulin (make the signal louder) in order to get the cells to respond. Blood sugar still looks normal on tests at this point even though it is taking larger and larger levels of insulin to maintain that normal blood sugar. This in turn just feeds into more and more resistance. Some researchers speculate that this resistance is partially driven by overly full cells trying to protect themselves, they don’t need more sugar so they stop listening to the insulin’s signal to take up more. Eventually, the pancreas cannot keep up and blood sugar starts to rise above normal levels and we finally detect there is an issue.
Additionally, all of that insulin keeps telling the liver and muscles to store energy. When they’re full, the excess blood sugar is sent to fat cells to be stored as body fat. It’s a vicious cycle that continues to spiral often unbeknown to the individual. There is a lot more to the insulin resistance story that we are still learning, but this simple explanation includes many of the main points that can lead us to better understand how our lifestyle choices can play into the problem. Next week, we will continue the conversation and discuss further what chronically high insulin levels can lead to.
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Forever yours in health,